Ophthalmology Commons^™

Improving Diabetic Retinopathy Screening In Africa: Patient Satisfaction With Teleophthalmology Versus Ophthalmologist-Based Screening, K. Kurji, D. Kiage, C. J. Rudnisky, K. F. Damji

Internal Medicine, East Africa

Purpose: To assess patient preference for diabetic retinopathy (DR) screening with teleophthalmology or face-to-face ophthalmologist evaluation in Nairobi, Kenya.

Materials and Methods: Fifty seven diabetic patients from a one-stop multidisciplinary diabetic clinic (consisting of a diabetologist, nurse educator, foot specialist, nutritionist, ophthalmologist, and neurologist) in Nairobi, Kenya were included if they had undergone both a teleophthalmology (stereoscopic digital retinal photographs graded by an ophthalmologist remotely) and a traditional clinical screening exam (face to face examination). A structured questionnaire with a 5-point Likert scale was developed in both English and Swahili. The questionnaire was administered over the telephone. Ten questions were …

Rapid Synaptic Vesicle Endocytosis In Cone Photoreceptors Of Salamander Retina., Matthew J. Van Hook, Wallace B. Thoreson

Journal Articles: Ophthalmology

Following synaptic vesicle exocytosis, neurons retrieve the fused membrane by a process of endocytosis to provide a supply of vesicles for subsequent release and maintain the presynaptic active zone. Rod and cone photoreceptors use a specialized structure called the synaptic ribbon that enables them to sustain high rates of neurotransmitter release. They must also employ mechanisms of synaptic vesicle endocytosis capable of keeping up with release. While much is known about endocytosis at another retinal ribbon synapse, that of the goldfish Mb1 bipolar cell, less is known about endocytosis in photoreceptors. We used capacitance recording techniques to measure vesicle membrane …

Retinal Optical Coherence Tomography Manifestations Of Intraocular Lymphoma., Tin Yan Alvin Liu, Mohamed Ibrahim, Millena Bittencourt, Yasir J. Sepah, Diana V. Do, Quan Dong Nguyen

Journal Articles: Ophthalmology

PURPOSE: Primary central nervous system lymphoma (PCNSL) is a rare disease. The index report describes a patient with intraocular lymphoma secondary to recurrent PCNSL and corresponding retinal findings on spectral domain optical coherence tomography (SD-OCT).

METHODS: Case report.

RESULTS: OCT changes were documented and correlated with the clinical course of intraocular lymphoma progression in the index patient. The OCT changes, manifested as hyperreflective material accumulation in the intraretinal and subretinal pigment epithelial spaces, were caused by lymphomatous infiltration.

CONCLUSION: SD-OCT can be useful in diagnosing and monitoring the progression or regression of intraocular lymphoma with retinal involvement.

Evaluation Of Very High- And Very Low-Dose Intravitreal Aflibercept In Patients With Neovascular Age-Related Macular Degeneration., Quan Dong Nguyen, Peter A. Campochiaro, Syed Mahmood Shah, David J. Browning, Henry L. Hudson, Peter L. Sonkin, Seenu M. Hariprasad, Peter K. Kaiser, Jason Slakter, Julia A. Haller, Diana V. Do, William Mieler, Karen Chu, Avner Ingerman, Robert Vitti, Alyson J. Berliner, Jesse Cedarbaum, Clear-It 1 Investigators

Journal Articles: Ophthalmology

PURPOSE: To determine bioactivity and duration of effect of intravitreal aflibercept injection (also known as vascular endothelial growth factor Trap-Eye) for neovascular age-related macular degeneration (AMD).

METHODS: In this double-masked, phase 1 study, 28 patients with lesions ≤12 disc areas, ≥50% active choroidal neovascularization (CNV), and best corrected visual acuity (BCVA) ≤20/40 were randomized 1:1 to a single intravitreal injection of aflibercept 0.15 or 4 mg. The primary end point was the change from baseline in central retinal/lesion thickness (CR/LT) at week-8. Secondary outcomes were the change from baseline BCVA, the change in CNV lesion size and area of leakage, …

Treatment Of Steroid-Induced Elevated Intraocular Pressure With Anecortave Acetate: A Randomized Clinical Trial., Ingeborg Stalmans, David G. Callanan, Monte S. Dirks, Marlene R. Moster, Alan L. Robin, Joachim Van Calster, Sally A. Scheib, Jaime E. Dickerson, Theresa A. Landry, Michael V. W. Bergamini

Wills Eye Hospital Papers

PURPOSE: The present study is the first randomized clinical trial designed to evaluate the intraocular pressure (IOP)-lowering effect of anecortave acetate (AA) administered at 3 doses (3, 15, or 30 mg) as an anterior juxtascleral depot (AJD) in patients experiencing elevated IOP due to corticosteroid therapy.

METHODS: This was a double-masked, randomized, placebo-controlled, multicenter, parallel group trial. Eligible patients had an IOP of at least 24 mmHg and an IOP increase of at least 10 mmHg relative to their IOP before treatment with steroids. A target IOP was established for each patient at baseline. Patients were randomized to 1 of …

Knowledge Of Patients' Visual Experience During Cataract Surgery: A Survey Of Eye Doctors In Karachi, Pakistan, Mohammad Zain Tauqir, Tanveer Anjum Chaudhry, Sehreen Mumtaz, Khabir Ahmad

Department of Surgery Docs

Abstract

BACKGROUND:

Several recent studies have recommended that ophthalmologists must be aware of the visual sensations (and their associated anxiety/fear) experienced by patients undergoing cataract surgery. We assessed the knowledge of a group of eye doctors in Pakistan regarding these phenomena.

METHODS:

This was a cross-sectional survey. Eye doctors (ophthalmologists, residents and medical officers) attending the Ophthalmological Society of Pakistan Annual Conference 2011, in Karachi were invited to participate in the study. A self-administered structured questionnaire was used to examine their knowledge of visual sensations and their associated anxiety/fear experienced by patients during cataract surgery. Simple frequencies and proportions were …

Candidal Retinitis, Carl D. Mele

The Medicine Forum

Mr. R.T. was a 49 year old male with recurrent Hepatitis C infection after orthotopic liver transplant, who presented with complications related to hemorrhagic pancreatitis. While on long term total parenteral nutrition, he developed blurry vision and Candida albicans fungemia. A fundus photograph revealed fungal endopthalmitis with focal areas of chorioretinitis. His vision improved significantly with serial intravitreal antifungal injections.

Withanolide Compounds As Inhibitors Of Fibrosis And Identification Of Molecular Targets For Anti-Fibrotic Drug Development, Royce Mohan, Paola Bargagna-Mohan

Ophthalmology and Visual Science Faculty Patents

Provided are methods for screening for drugs effective for treating fibrotic conditions. One screening method comprises exposing a cell to a test compound, monitoring the effect of the test compound on the amount or form of a cell molecule, comparing the amount or form of the cell molecule with the result obtained by treatment of the cell with an anti-fibrotic -effective amount of a withanolide compound, and selecting a drug effective for treating a fibrotic disease based on the ability of the test compound to provide the effect obtained by the withanolide compound on the cell molecule. Also provided is …

Nucleic Acid And Non-Nucleic Acid-Based Reprogramming Of Adult Limbal Progenitors To Pluripotency, Sowmya Parameswaran, Sudha Balasubramanian, Norbert Babai, Carolina B. Deldebbio, Donald W. Harms, Channabasavaiah B. Gurumurthy, Mahendra S. Rao, J. Graham Sharp, Iqbal Ahmad

Journal Articles: Ophthalmology

Reprogramming somatic cells to a pluripotent state by nucleic acid based (NAB) approaches, involving the ectopic expression of transcription factors, has emerged as a standard method. We recently demonstrated that limbal progenitors that regenerate cornea are reprogrammable to pluripotency by a non-NAB approach through simple manipulation of microenvironment thus extending the possible therapeutic use of these readily accessible cells beyond the proven treatment of corneal diseases and injury. Therefore, to determine the validity and robustness of non-cell autonomous reprogramming of limbal progenitors for a wider clinical use, here, we have compared their reprogramming by non-NAB and NAB approaches. We observed …

Gene Expression In Human Accessory Lacrimal Glands Of Wolfring, John L. Ubels, Ilene K. Gipson, Sandra J. Spurr-Michaud, Ann S. Tisdale

University Faculty Publications and Creative Works

The accessory lacrimal glands are assumed to contribute to the production of tear fluid, but little is known about their function. The goal of this study was to conduct an analysis of gene expression by glands of Wolfring that would provide a more complete picture of the function of these glands. METHODS: Glands of Wolfring were isolated from frozen sections of human eyelids by laser microdissection. RNA was extracted from the cells and hybridized to gene expression arrays. The expression of several of the major genes was confirmed by immunohistochemistry. RESULTS: Of the 24 most highly expressed genes, 9 were …

Gene Expression In Human Accessory Lacrimal Glands Of Wolfring, John L. Ubels, Ilene K. Gipson, Sandra J. Spurr-Michaud, Ann S. Tisdale

University Faculty Publications and Creative Works

PURPOSE: The accessory lacrimal glands are assumed to contribute to the production of tear fluid, but little is known about their function. The goal of this study was to conduct an analysis of gene expression by glands of Wolfring that would provide a more complete picture of the function of these glands. METHODS: Glands of Wolfring were isolated from frozen sections of human eyelids by laser microdissection. RNA was extracted from the cells and hybridized to gene expression arrays. The expression of several of the major genes was confirmed by immunohistochemistry. RESULTS: Of the 24 most highly expressed genes, 9 …

Visual Function After Correction Of Distance Refractive Error With Ready-Made And Custom Spectacles: A Randomized Clinical Trial., Christopher J. Brady, Andrea C Villanti, Monica Gandhi, David S Friedman, Lisa Keay

Wills Eye Hospital Papers

PURPOSE: To evaluate patient-reported outcome measures with the use of ready-made spectacles (RMS) and custom spectacles (CS) in an adult population in India with uncorrected refractive error (URE).

DESIGN: Prospective, double-masked, randomized trial with 1-month follow-up.

PARTICIPANTS: A total of 363 adults aged 18 to 45 years with ≥1 diopter (D) of URE (RMS, n = 183; CS, n = 180).

INTERVENTION: All participants received complete refraction and were randomized to receive CS (full sphero-cylindrical correction) or RMS based on the spherical equivalent for the eye with lower refractive error but limited to the powers in the RMS inventory.

MAIN …

Choroidal Neovascularization Regression On Fluorescein Angiography After Vegf Blockade., Diana V. Do, Lark Greenwald, Mohamed Ibrahim, Yasir J. Sepah, Quan Dong Nguyen

Journal Articles: Ophthalmology

BACKGROUND: Intravitreal vascular endothelial growth factor (VEGF) inhibitors stabilize vision in a majority of patients with neovascular age-related macular degeneration (AMD) and can improve vision in almost 40% of patients. However, some individuals who respond to anti-VEGF treatment still lose vision due to the formation of geographic atrophy (GA). While optical coherence tomography is often the primary imaging modality used, fluorescein angiography (FA) can provide useful information on GA development after choroidal neovascularization (CNV) regression.

METHODS: A retrospective chart review was conducted to evaluate the changes seen on FA over a 47-month period for 3 patients with neovascular AMD treated …

Isolated Endogenous Nocardia Endophthalmitis After Immunosuppression., Lisa Y. Chen, Muge R. Kesen, Abdalhossein Ghafourian, Quan Dong Nguyen, Charles G. Eberhart, Diana V. Do

Journal Articles: Ophthalmology

PURPOSE: This study is aimed to report a case of endogenous Nocardia endophthalmitis in the setting of immunosuppression from chronic steroid use.

METHODS: A case report was conducted.

RESULTS: A 79-year-old woman presented with decreased vision with floaters in the left eye. Ophthalmic examination revealed severe inflammation in the anterior chamber, vitreous opacities, and retinal detachment. Vitreous cultures grew Nocardia farcinica without any systemic foci of infection found during further workup. The patient was treated with intravitreal amikacin and oral trimethoprim-sulfamethoxazole, and her retinal detachment was later repaired in the operating room. The patient has since remained stable with no …

Characterization Of Macular Lesions In Punctate Inner Choroidopathy With Spectral Domain Optical Coherence Tomography., Roomasa Channa, Mohamed Ibrahim, Yasir J. Sepah, Peykan Turkcuoglu, Jeong Hee Lee, Afsheen Khwaja, Elham Hatef, Millena Bittencourt, Jangwon Heo, Diana V. Do, Quan Dong Nguyen

Journal Articles: Ophthalmology

PURPOSE: Punctate inner choroidopathy (PIC) is an ocular inflammatory disease. Spectral domain optical coherence tomography (SD-OCT) allows detailed visualization of retinal and choroidal structures. We aimed to describe the retinal changes on SD-OCT associated with PIC lesions localized in the macula.

METHODS: Retrospective case series: PIC lesions not associated with choroidal neovascularization (CNV) and captured by macular SD-OCT scans were identified and characterized.

RESULTS: Twenty-seven PIC lesions from seven patients (eight eyes) were identified and classified into four categories according to disease activity and temporal changes. Among clinically inactive patients, two main patterns were noted on OCT: (1) retinal pigment …

Genetics For The Ophthalmologist., Karthikeyan A Sadagopan, Jenina Capasso, Alex V Levin

Wills Eye Hospital Papers

The eye has played a major role in human genomics including gene therapy. It is the fourth most common organ system after integument (skin, hair and nails), nervous system, and musculoskeletal system to be involved in genetic disorders. The eye is involved in single gene disorders and those caused by multifactorial etiology. Retinoblastoma was the first human cancer gene to be cloned. Leber hereditary optic neuropathy was the first mitochondrial disorder described. X-Linked red-green color deficiency was the first X-linked disorder described. The eye, unlike any other body organ, allows directly visualization of genetic phenomena such as skewed X-inactivation in …

Automatic And Robust Calibration Of Optical Detector Arrays For Biomedical Diffuse Optical Spectroscopy, Michael A. Mastanduno, Shudong Jiang, Roberta Diflorio-Alexander, Brian W. Pogue, Keith Paulsen

Dartmouth Scholarship

The design and testing of a new, fully automated, calibration approach is described. The process was used to calibrate an image-guided diffuse optical spectroscopy system with 16 photomultiplier tubes (PMTs), but can be extended to any large array of optical detectors and associated imaging geometry. The design goals were accomplished by developing a routine for robust automated calibration of the multi-detector array within 45 minutes. Our process was able to characterize individual detectors to a median norm of the residuals of 0.03 V for amplitude and 4.4 degrees in phase and achieved less than 5% variation between all the detectors …

Attentive And Pre-Attentive Processes In Change Detection And Identification, Howard C. Hughes, Gideon Paul Caplovitz, Rebecca A. Loucks, Robert Fendrich

Dartmouth Scholarship

In studies of change blindness, observers often have the phenomenological impression that the blindness is overcome all at once, so that change detection, localization and identification apparently occur together. Three experiments are described that explore dissociations between these processes using a discrete trial procedure in which 2 visual frames are presented sequentially with no intervening inter-frame-interval. The results reveal that change detection and localization are essentially perfect under these conditions regardless of the number of elements in the display, which is consistent with the idea that change detection and localization are mediated by pre-attentive parallel processes. In contrast, identification accuracy …

Healing Of Cornea Following An Electric Burn, Tanveer Anjum Chaudhry, Farheen Shaikh, Khabir Ahmad

Department of Surgery Docs

ABSTRACT Electrical injuries have become a significant health problem in developing countries because of increase in access to electricity in the last few decades and lack of adequate safety measures. Electrical injuries of eyes are relatively uncommon. A case report of a rapid and complete corneal healing accompanied by satisfactory visual recovery after an electric burn event in a 20-year-old male is reported. The patient had accidental exposure to high voltage live wire while he was repairing it, resulting in severe ocular and superficial body burn. He was not wearing any protective equipment at the time of injury. On examination, …

A Refractive Surgery Candidate With Optic Nerve Head Cupping., Ivan Goldberg, L Jay Katz, Kaweh Mansouri, Mohammad Pakravan, Shahin Yazdani

Wills Eye Hospital Papers

No abstract provided.